Development and Validation of a Scale to Assess Knowledge, Attitudes and Practices Regarding Downtime Management in...

Downtime refers to the period during CRRT treatment when the filter is not performing solute clearance or ultrafiltration. It is an important component of continuous renal replacement therapy (CRRT) nursing quality indicators. To improve CRRT nursing quality, it is crucial to assess the level of intensive care unit (ICU) nurses' management of CRRT downtime.

To develop a questionnaire to assess knowledge, attitude and practice (KAP) regarding downtime management in continuous renal replacement therapy among ICU nurses and test the validity and reliability of the scale.

Based on the knowledge-attitude-practice (KAP) theory, a preliminary scale was formed through a literature review, expert consultation, group discussion and pre-surveys. From August to September 2024, a survey was conducted with nurses from 14 ICUs across 12 provinces and cities, including Hubei Province, Guangxi Province and Chongqing City, to analyse the reliability and construct validity of the scale. From September to October 2024, a questionnaire survey was conducted with nurses from 16 ICUs across six provinces and cities, including Hubei Province, Henan Province and Shanxi Province, for confirmatory factors.

A total of 255 and 320 nurses participated in the first and second phase of the study. The KAP scale for ICU nurses' CRRT downtime management consists of 37 items, including knowledge (9 items), attitudes (15 items) and practices (13 items) across three dimensions. The item-content validity index (I-CVI) of the scale ranged from 0.820 to 1.000, with the average scale-level content validity index (S-CVI/Ave) being 0.902. Exploratory factor analysis extracted three common factors, with a cumulative variance contribution rate of 70.331%. Confirmatory factor analysis showed good model fit. The overall scale's Cronbach's α coefficient was 0.971, and the test-retest reliability was 0.931.

The developed KAP scale for ICU nurses' CRRT downtime management demonstrates good reliability and validity and can be used to measure the KAP levels of ICU nurses in managing CRRT downtime.

This scale provides a standardised tool for assessing ICU nurses' competence in CRRT downtime management. It helps nursing managers identify specific weaknesses in nurses' knowledge, attitudes and practice, enabling targeted training and guidance. This, in turn, can enhance nurses' practical skills in managing downtime, reduce the duration of CRRT treatment interruptions and ultimately improve patient clinical outcomes.